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CARDIAC DRUGS > Cardic 3 > Flashcards

Cardic 3 Flashcards

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1
Q

Calcium chloride

Drug classification

A

Mineral

Electrolyte

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2
Q

Calcium chloride

Mechanism of action

A

Replacement of elemental calcium -> dissociates rapidly to Ca2+ and Cl- ions -> positive inotropy and chronotropy

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3
Q

Calcium chloride

Pharmacokinetics

A

Onset: immediate
Peak: unknown
Duration: varies
Half-life: N/a

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4
Q

Calcium chloride

Indications / field use

A

Acute hyperkalemia
Ca2+ channel blocker toxicity
Crush syndrome
Abdominal muscle spam from brown spider or man of war jellyfish
Cardiac arrest secondary to suspected hyperkalemia (known dialysis pt, etc)

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5
Q

Calcium chloride

Contraindications

A

Hypercalcemia

Pt taking digoxin

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6
Q

Calcium chloride

Side effects / adverse reactions

A

Bad dysrhythmias need some calcium

Bradycardia,Dysrhythmias, Nausea and vomiting, Syncope, Cardiac arrest

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7
Q

Calcium chloride

Dose (Adult)

A

1g slow IV/IO over 5 minutes

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8
Q

Calcium chloride

Dose (pedi)

A

20mg/kg slow IV/IO

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9
Q

Calcium chloride

Precautions

A

Can cause tissue necrosis at injection side; ensure patent IV line

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10
Q

Calcium chloride

Drug-Drug Interactions

A

Forms PPT w/ NaHCO3, flush tubing between administration
Digitalis toxicity when administered to pt currently taking digitalis / digoxin - inhibits Ca2+ channels causing “stone heart”

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11
Q

Calcium Gluconate

Drug classification

A

Mineral

Electrolyte

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12
Q

Calcium Gluconate

Mechanism of action

A

Replacement of elemental calcium -> dissociates rapidly to Ca2+ and gluconate ions -> positive inotropy and chronotropy

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13
Q

Calcium Gluconate

Pharmacokinetics

A

Onset : immediate
Peak : unknown
Duration : varies
Half-life : N/a

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14
Q

Calcium Gluconate

Indications / field use

A

Acute hyperkalemia
Ca2+ channel blocker toxicity
Cardiac arrest secondary to suspected hyperkalemia (known dialysis pt, etc)

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15
Q

Calcium Gluconate

Side effects / adverse reactions

A

Bad dysrhythmias need some calcium

Bradycardia, dysrhythmias, nausea and vomiting, syncope, cardiac arrest

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16
Q

Calcium Gluconate

Dose (adult)

A

2g slow IV/IO over 5 minutes

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17
Q

Calcium Gluconate

Dose (pedi)

A

60mg/kg slow IV/IO over 5 minutes

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18
Q

Calcium Gluconate

Precautions

A

Can cause tissue necrosis at injection site, ensure patent IV line

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19
Q

Calcium Gluconate

Drug-Drug interactions

A

Forms PPT w/ NaHCO3, flush tubing between administration
Digitalis toxicity when administered to pt currently taking digitalis/digoxin - inhibits Ca2+ channels causing “stone heart”

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20
Q 
Dopamine HCL (Intropin) 
Drug classification
A

Sympathomimetic
Sympathetic agonist
Catecholamine

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21
Q 
Dopamine HCL (Intropin) 
Mechanism of action
A

Alpha 1 agonist -> second messenger release of Ca2+ in VSMC -> peripheral vasoconstriction -> increased SVR -> increased BP
Beta 1 agonist -> increased intracellular Ca2+ in cardiac cells -> positive inotropy, chronotropy, dromotropy

the mechanism for this drug is dose dependent

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22
Q 
Dopamine HCL (Intropin) 
Pharmacokinetics
A

Onset : <5 minutes
Peak : 5-8 minutes
Duration : <10 minutes
Half-life : 2 minutes

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23
Q 
Dopamine HCL (Intropin) 
Indications / field use
A

Cardiogenic shock
Symptomatic bradycardia
Septic shock following fluid resuscitation

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24
Q 
Dopamine HCL (Intropin) 
Contraindications
A

Uncorrected hypovolemia (if profoundly hypotensive, may give IV fluids concurrently)

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25
``` Dopamine HCL (Intropin) Side effects / adverse reactions ```
This Drug Does Not Help Neither Chest pain or Extravasated necrosis Tachycardia, Dyspnea, Dysrhythmias (a-fib, PVC's), HA, Nausea and vomiting, Chest pain, Extravasated necrosis
26
``` Dopamine HCL (Intropin) Dose (adult) ```
2-5mcg/kg/min IV/IO infusion (low dose) causes increased blood flow to mesentery renal (GUT) 5-10mcg/kg/min IV/IO infusion (medium dose) stimulates beta effects 10-20mcg/kg/min IV/IO infusion (high dose) stimulates alpha effects
27
``` Dopamine HCL (Intropin) Dose (pedi) ```
2-20mcg/kg/min IV/IO infusion
28
``` Dopamine HCL (Intropin) Precautions ```
Must be kept out of direct sunlight
29
``` Dopamine HCL (Intropin) Drug-Drug interactions ```
NONE
30
Norepinephrine (levophed) | Drug classification
Sympathomimetic Sympathetic agonist Catecholamine
31
Norepinephrine (levophed) | Mechanism of action
* primary* alpha 1 agonist -> second messenger release of Ca2+ in VSMC -> peripheral vasoconstriction -> increased SVR -> increased BP * secondary* beta 1 agonist -> increased intracellular Ca2+ in cardiac cells -> positive inotropy, chronotropy, dromotropy
32
Norepinephrine (levophed) | Pharmacokinetics
Onset : <1 minute Peak : <2 minutes Duration : 1-2 minutes Half-life : 3 minutes
33
Norepinephrine (levophed) | Indications / field use
Cardiogenic shock Septic shock following fluid resuscitation Neurogenic shock
34
Norepinephrine (levophed) | Contraindications
Hypovolemia
35
Norepinephrine (levophed) | Side effects / adverse reactions
Norepi Tries to Help Really Dangerous Agonists not Dysrhythmias Nausea and vomiting, tremulousness, HA, Reflex bradycardia, Dizziness, Anxiety, Dysrhythmias
36
Norepinephrine (levophed) | Dose (adult)
1-30mcg/min IV/IO infusion - titration to systolic BP 90mmHg
37
Norepinephrine (levophed) | Dose (pedi)
0.1-2mcg/kg/min IV/IO infusion - titration to normotensive systolic BP
38
Norepinephrine (levophed) | Precautions
Can cause tissue necrosis with extraversion Caution with CAD *lead to increased myocardial oxygen demand*
39
Norepinephrine (levophed) | Drug-Drug interactions
MAOI and TCA may potentiate cardiovascular effects
40
Phenylephrine (Neo-Synephrine) | Drug classification
Sympathomimetic | Sympathetic agonist
41
Phenylephrine (Neo-Synephrine) | Mechanism of action
Alpha 1 agonist -> second messenger release of calcium in VSMC -> peripheral vasoconstriction -> increased SVR -> increased BP
42
Phenylephrine (Neo-Synephrine) | Pharmacokinetics
Onset : immediate Peak : <1 minute Duration : 15-20 minutes Half-life : 2 minutes
43
Phenylephrine (Neo-Synephrine) | Indications / field use
Septic shock following fluid resuscitation | Neurogenic shock
44
Phenylephrine (Neo-Synephrine) | Contraindications
Cardiogenic shock
45
Phenylephrine (Neo-Synephrine) | Side effects / adverse reactions
Hypertension Decreases Need to Titrate Dysrhythmias, hypertension, nausea and vomiting, tremulousness
46
Phenylephrine (Neo-Synephrine) | Dose (adult)
100-180mcg/min IV/IO infusion until BP > 90 systolic
47
Phenylephrine (Neo-Synephrine) | Dose (pedi)
0.1-0.5mcg/kg/min
48
Phenylephrine (Neo-Synephrine) | Precautions
Can cause tissue necrosis with extravasation
49
Phenylephrine (Neo-Synephrine) | Drug-Drug Interactions
Deactivated by alkaline solutions | Caution in pts with digitalis toxicity, may aggravate tachydysrhythmias
50
Procainamide (Pronestyl) | Drug classification
Antidysrhythmic
51
Procainamide (Pronestyl) | Mechanism of action
Class 1A antiarrhythmic / moderate Na+ channel blocker -> decreases slope and amplitude of phase 0 depolarization for non-pacemaker action potential
52
Procainamide (Pronestyl) | Pharmacokinetics
Onset : 10-30 minutes Peak : 15-20 minutes Duration : 3-6 hours Half-life : 3 hours
53
Procainamide (Pronestyl) | Indications / field use
Recurrent cardiac arrest secondary to VT/VF refractory to amiodarone
54
Procainamide (Pronestyl) | Contraindications
Severe conduction disturbances, especially 2nd degree and 3rd degree heart blocks PVC’s with bradycardia
55
Procainamide (Pronestyl) | Side effects / adverse reactions
Drowsiness, seizures, confusion, hypotension, bradycardia, heart blocks, nausea & vomiting, respiratory and cardiac arrest
56
Procainamide (Pronestyl) | Dose (adult)
20mg/min infusion until one of D/C precautions observed | 1-4mg/min maintenance
57
Procainamide (Pronestyl) | Dose (pedi)
15mg/kg IV/IO over 30-60 minutes
58
Procainamide (Pronestyl) | Precautions
``` D/C if: Dysrhythmia is suppressed Hypotension occurs QRS complex widens by 50% 17mg/kg of procainamide has been administered ```
59
Procainamide (Pronestyl) | Drug-Drug Interactions
Chance of neurotoxicity increases if given with lidocaine
60
Magnesium Sulfate | Drug classification
Electrolyte | Antidysrhythmic
61
Magnesium Sulfate | Mechanism of action
* SMC* Ca2+ channel blocker -> inhibits Ca2+ entry and subsequent interaction between actin and myosin in SMC -> smooth muscle relaxation and dilation of blood vessels and bronchial tree * Cardiac* Ca2+ channel blocker -> negative inotropy, chronotropy, dromotropy
62
Magnesium Sulfate | Pharmacokinetics
Onset : immediate IV, 1 hour IM Peak : varies Duration : 1 hour Half-life : N/a
63
Magnesium Sulfate | Indications / field use
Severe asthma / bronchospasm Severe refractory VF or pulseless VT with hypoMg2+ Torsades de pointes Eclampsia
64
Magnesium Sulfate | Contraindications
Third degree heart block, hypotension
65
Magnesium Sulfate | Indications / Field Use
Severe asthma / Bronchospasm Severe refractory VF or pulseless VT w hypoMg2+ Torsades de Pointes Eclampsia
66
Magnesium Sulfate | Contraindications
There degree heart block, hypotension
67
Magnesium Sulfate | Side Effects / Adverse Reactions
Dude, First Itching Becomes Rashes Due to Severe Respiratory Hypotension Drowsiness, Flushing, Itch, Bradycardia, Rash, Dysrhythmias, Sweating, Respiratory depression, Hypotension
68
Magnesium Sulfate | Dose (Adult)
Asthma: 2g in 10cc NS IV/IO infusion over 10 minutes VT, VF, Torsades-no pulse: 2g IV/IO over 1-2 minutes VT/Torsades: 1-2g in 50-100cc NS IV/IO over 5-60 minutes Eclampsia: 4mg in 20mL IV/IO over 5 minutes
69
Magnesium Sulfate | Dose (Pedi)
Asthma: 25-50mg/kg IV/IO infusion over 15-30 minutes, max dose 2g VT/Torsades - no pulse: 25-50mg/kg IV/IO, max dose 2g VT/Torsades + pulse: 25-50mg/kg IV/IO over 10-20 minutes, max dose 2g
70
Magnesium Sulfate | Precautions
No benefit with COPD Caution with impaired renal function Watch for respiratory depression
71
Magnesium Sulfate | Drug-Drug Interactions
Cardiac conduction abnormalities if give with digitalis

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